Phonation Research Articles

First episode psychosis in a young person with a diagnosis of Autistic Spectrum Disorder: A Case report

IntroductionPsychotic disorders are significant comorbidities in young people with Autistic Spectrum Disorder (ASD). Evidence suggests that ASD & psychosis present with overlapping clinical features & cognitive symptoms leading to misdiagnosis (Trevisan et al. Front.Psych 2020;11:548). Clinicians encounter diagnostic dilemma during assessment of psychosis in adolescents with ASD.ObjectivesTo discuss the clinical challenges in the assessment & treatment of young people with ASD & comorbid psychosis.MethodsA case report of a young girl with ASD & comorbid psychotic illness.ResultsA young girl with ASD was admitted to CAMHS inpatient Unit with unusual beliefs & perceptual disturbances. She reported hearing the voice of ‘Hydrogis’ who was talking to her about his girlfriend. She made a voodoo doll & tried to set it on fire, as she believed that this would kill the girlfriend. She also heard voices of characters from a TV show, discussing her in third person. She absconded from home due to the distress associated. She attempted suicide by tying a ligature. She was seen responding to external stimuli, laughing incongruously & was thought disordered. Despite never being to USA, she spoke in American accent. She lacked insight & struggled to differentiate reality from fantasy. The aim of admission was to determine if the symptoms were part of ASD or a psychotic disorder. She had medication free assessment but continued to be very distressed. We commenced Aripiprazole which was optimised. She responded well to the treatment & was discharged to the care of Early Intervention in Psychosis team with partial remission of symptoms.ConclusionsHistorically psychotic illnesses & ASD were thought to be closely linked. Research suggest that they are two separate disorders with specific onset, progress, signs & symptoms. ASD might be misdiagnosed as psychosis as difficulties in communication may resemble thought disorder, ‘melt down’ may mimic catatonia & difficulties in recognising others’ intentions may mimic paranoia. Our patient was experiencing first episode psychosis in late adolescence. This age of onset is consistent with research findings. A study to differentiate between ASD & psychosis found that positive symptoms like hallucinations & delusions were suggestive of psychosis while odd emotional gestures, stereotyped speech & restricted interests indicated ASD. Our patient predominantly had positive symptoms of delusions, hallucinations & thought disorder, hence our diagnosis of psychotic episode. In some cases, it is difficult to differentiate childhood fantasies from delusional beliefs (Ribolsi et al. Front.Psych 2022;13:768586). Bleuler explains that children with ASD replace imperfect realities with imaginations & hallucinations but Michael Rutter claims that autistic children lack fantasy. There are varying views on this subject & this is the challenge we faced when treating this young person.Disclosure of InterestNone Declared

Experiences of Patients with Unilateral Vocal Fold Paralysis: A Mixed-Methods Study of the Insider’s Perspective

ObjectiveUnilateral vocal fold paralysis (UVFP) is often characterized by severe dysphonia and has a significant impact on a patient’s communication in daily and vocational situations. Having a better understanding of how UVFP influences quality of life and patient experiences can help improve patient-centered care in this population. Therefore, the purpose of this study was to explore the lived experiences of patients with UVFP. MethodsTwenty-five adults with UVFP (age range: 39 – 84 years) participated in the study. Quantitative data were collected from 22 participants, using the Voice Handicap Index (VHI), Dysphonia Severity Index (DSI), and Acoustic Voice Quality Index (AVQI). Qualitative data were collected from 25 individual semi-structured interviews, which were recorded, transcribed, and analyzed with the software program NVivo. The interviews were coded using an inductive thematic approach. ResultsQuantitative results showed a mean DSI of -1.6, mean AVQI of 3.80, and mean VHI of 45.8 in the participant group. A statistically significant, moderate (positive) correlation was found between VHI and time after onset (in years). From the qualitative analysis of the interviews, four main themes were identified: emotional impact, psychosocial impact, physical complaints, and coping strategies. Voice problems caused by UVFP generally had a negative impact on patients’ emotional and psychological well-being, with considerable effects on participation, self-identity, and professional activity. Participants demonstrated a combination of problem-focused and emotion-focused coping strategies to accommodate to these issues. Half of the participant group also showed avoidance as a coping style. VHI scores were significantly higher in participants who reported experiencing current emotional and participation problems due to UVFP, and who had not yet accepted their new voice. ConclusionThe themes from this study emphasize the importance of focused anamnesis and emotive counseling in practice, with specific attention to the psychosocial and emotional impact of UVFP. Data Availability StatementData is available from the authors upon request due to privacy reasons.

Cepstral Analysis of Voice in School-Aged Children

Dysphonia in school-aged children is attributed primarily to hyperfunctional use of voice. These can be identified through effective protocols using both acoustic and auditory-perceptual analyses. The current study aimed to investigate voice characteristics in school children aged 4-17years using auditory-perceptual rating and cepstral measures of voice. This is a descriptive cross-sectional observational study. Four hundred and fifty-seven recordings of sustained phonation of /a/ in children and adolescents obtained in a quiet room using Zoom h1 voice recorder were analyzed using auditory-perceptual evaluation by three speech-language pathologists using Grade of overall dysphonia, Roughness, Breathiness, Asthenia, and Strain(GRBAS) rating scale. The samples were classified based on age into five groups: 1) 4 to 6; 11 years 2) 7-8; 11 years, 3) 9-11; 11years 4) 12-13; 11years and 5) 14-16; 11 years. PRAAT software was used to extract Cepstral Peak Prominence (CPP) and Cepstral Peak Prominence Smoothed (CPPS). Inter-rater reliability was assessed for both auditory-perceptual and acoustic analysis. Auditory-perceptual analysis revealed dysphonia in 7.8% of samples with higher rate in males than females. Inter-rater reliability for auditory-perceptual rating was found to be good (Intraclass Corelation Coefficient-0.83). Independent t test revealed statistically significant difference (P<0.001) in both cepstral measures and mean values were lower in dysphonic than normal group. Gender effect was present for CPP in group 5(14-16;11 years) and CPPS in group 4 (12-13; 11years). One-way analysis of variance within groups in males (P<0.005) revealed statistical difference in both cepstral measures but not in females. Statistically significant difference was not found between ratings of both speech language pathologists for both CPP (P=0.929) and CPPS (P=0.965) values indicating the ratings to be reliable. Pediatric dysphonia has received less attention when compared to adults. Assessing school-aged children for dysphonia using both auditory-perceptual and acoustic measures would aid in identifying those at risk to make appropriate referrals and plan further intervention.

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Acoustic characteristics of voice production in virtual reality-simulated and physical environments: a comparative study in university professors

This study investigated the reliability of a virtual reality-simulated classroom to generate a comparable self-perception of voice quality and acoustic effects of phonation to a real classroom in a group of teachers, and sense of presence. Thirty university professors participated in the study and were required to produce loud connected speech by reading a 100-word text in two conditions: (1) in a real classroom including a group of students, and (2) in a virtual replica of the classroom consisting of a 360-degree video of the same classroom and students, which was displayed using a head mounted display. Ambient noise was controlled in both conditions by playing classroom noise through headphones. The self-perception of voice quality, the long-term average spectrum and smooth cepstral peak prominence were estimated in both conditions. The sense of presence generated by virtual reality was measured after interacting with the virtual classroom. There were no statistically significant differences in the self-perception of voice quality or in the acoustic measures of voice production between conditions. The sense of presence in the virtual classroom was high. Our findings suggest that a virtual reality-simulated classroom generate comparable self-perception of voice quality and acoustic effects of phonation to the real classroom, and a high sense of presence, in a group of teachers. Additionally, it is important to highlight the potential of virtual reality to enhance the ecological validity of acoustic assessment of voice production in laboratories and clinical settings.

Impact of perceptual-learning strategies and background noise on disordered speech intelligibility

Objective: There is a plethora of research showing reduced speech intelligibility for a variety of voice disorders (i.e., dysphonia, alaryngeal). Therapeutic approaches to improve intelligibility typically involve targeting the speaker (e.g., clear speech, reduced rate) with minimal attention to the listener. Therefore, there were three purposes of this study: 1) to determine the impact of background noise on the speech intelligibility of disordered speakers; 2) to determine the impact of providing listeners with perceptual-learning strategies on the speech intelligibility of speakers with a voice disorder; and 3) to determine if subjective ratings of voice quality can predict speech intelligibility. Methods: Sentences were recorded from 12 speakers (2 typical, 3 alaryngeal, 7 dysphonic). Sentences were divided into one of three groups of signal-to-noise ratios (SNR: quiet, +5 dB SNR, and 0 dB SNR) and individually presented to 129 healthy listeners divided into one of three groups (i.e., control, acknowledgment of disorder, cognitive-perceptual strategies). Orthographic transcription was used to assess speech intelligibility. In addition, three expert listeners provided subjective voice quality ratings of all speakers. Results: Listeners had significantly more intelligibility errors with increased background noise (p &lt;.001) and providing strategies to listeners did not result in a statistical improvement level F(6, 486) = 1.53, p = .17, η2p = 0.02. Regression analysis showed that the subjective voice quality overall severity was able to predict speech intelligibility in the noisy condition (0 dB SNR), accounting for 37% of the variance, R2 = .365, F(1,10) = 5.759, p = .037. Conclusion: Results suggest that increased background noise has a deleterious effect on the speech intelligibility of those with a voice disorder but that providing listeners with strategies in hopes of improving speaker intelligibility was not successful. Results did provide support, however, for the use of subjective voice quality ratings as a potential index of speech intelligibility.

Verbal and Nonverbal Communication in the Rehabilitation Process for Drug Addicts at Rancamaya Singaparna Mental Hospital: An Interactional Analysis

This research investigates communication behavior, both verbal and nonverbal, that occurs in the rehabilitation process for drug addicts at the Rancamaya Mental Hospital. These data are presented in the context of communication between medical staff and residents, and include various aspects of communication such as facial expressions, hand gestures, spatial arrangement (proxemics), use of time (chronemics), clothing, as well as voice characteristics and sound intensity (paralinguistics). The research results show that nonverbal communication plays an important role in building empathy, conveying messages, and creating an effective rehabilitation environment. This research provides in-depth insight into how nonverbal communication influences the rehabilitation process of drug addicts.

Comparison of the Outcome of Surgery and Radiotherapy in the Treatment of Early Carcinoma of the Larynx

Background: The most prevalent disease to afflict the head and neck region is laryngeal cancer. The early stage of this disease, T1T2N0M0, has a higher chance of recovery than the other phases. Radiation therapy and surgery are its therapeutic techniques.&#x0D; Objective: To Compare the outcome of surgery and radiotherapy in the treatment of early carcinoma of the larynx&#x0D; Methods: This cross-sectional study was carried out at tertiary hospital Dhaka from January 2022 to January 2023. Where A total of 200 Patients of carcinoma of the larynx are evaluated properly by detailed history taking, clinical examination and relevant investigation. During the study two groups of patients were dealt separately; Group-1: Surgery using LASER, n=100 and Group-2: radiotherapy, n=200. All the patients were followed up after 2 weeks, 1 month and then three monthly for one year.&#x0D; Results: During the study, supraglottis carcinoma was found in 65% of radiotherapy group and 70% in surgery group, glottic carcinoma was 35% &amp; 30%, respectively in radiotherapy and surgery group. No case found with subglottic carcinoma. Where in surgery group 7% patients had haematoma, 5% patients had seroma &amp; pharyngeal stenosis. In radiotherapy group 2.5% Severe radiation necrosis of skin &amp; 3% had Respiratory distress following radiotherapy. . In the radiotherapy group, 25% cases were scored as normal and 45% as good. For the surgery group, 40% patients had good voice and speech, 35%r had moderate voice and speech, and 5% had poor voice and speech. This difference was statistically significant (p=.001). 14% of the irradiation group had a primary site recurrence compared with 20% in the surgery group at 12th months. There was a significant difference in the pattern of recurrence in the neck between the two treatment groups. Only 5% of those who were treated with irradiation had a recurrence in the neck. 14% of patients in the surgery group had a recurrence in the neck; this difference was statistically significant.&#x0D; Conclusions: When treating early laryngeal cancer, radiation therapy and surgery are equally successful. However, patients who had radiation therapy had much improved speech and voice quality compared to those who received surgery.

Application of Platysma Myocutaneous Flap in Surgical Repair after T2-3 Glottic Carcinoma Resection.

Numerous methods and materials are available for vertical partial laryngectomy. In this study, the reparative effects of the platysma myocutaneous flap (PMF) and ribbon myocutaneous flap (RMF) on the postoperative voice quality of patients were compared to provide a reference for selecting a method conducive to improving postoperative voice quality. A retrospective analysis was performed on patients with unilateral T2-3 glottic carcinoma. Following vertical partial laryngectomy, the defect was repaired with a PMF or simple RMF. Twelve months after surgery, voice quality was assessed according to voice acoustics, aerodynamics, and subjective perceptual evaluation, and glottic morphology was recorded using a laryngeal stroboscopy. A total of 70 patients were identified, including 54 in the PMF group and 16 in the RMF group. The PMF group was superior to the RMF group in terms of voice quality assessed by voice acoustics, aerodynamics, and subjective perceptual evaluation. In the PMF group, 72.2% of patients performed phonation with their vocal cords, and approximately 27.8% of patients were affected by supraglottic compression. In the RMF group, 81.3% of patients were affected by supraglottic compression. No significant difference was found in the 5-year survival rate between the two groups. For defect repair following vertical partial laryngectomy, a PMF can allow better postoperative voice quality to be achieved than an RMF because a PMF can provide more tissue (including strap muscle under the flap) for padding, which enables the glottic portion corresponding to the vocal cord to close well. 3 Laryngoscope, 134:3181-3186, 2024.

Voice self-assessment in individuals with Parkinson's Disease as compared to general voice disorders

BackgroundIndividuals with Parkinson's Disease (IwPD) often fail to adjust their voice in different situations, without awareness of this limitation. Clinicians use self-report questionnaires that are typically designed for individuals with General Voice Disorders (GVD) in the vocal assessment of IwPD. However, these instruments may not consider that IwPD have a reduced self-perception of their vocal deficits. This study aimed to compare self-reported vocal symptoms and voice loudness between IwPD and GVD. Methods28 IwPD and 26 with GVD completed the Voice Symptom Scale (VoiSS) questionnaire to evaluate their voice self-perception. Vocal loudness (dB) was also assessed. Univariate and multivariate analyses were used to compare the outcomes from these measures between the two groups. Principal Component Analysis and Hierarchical Clustering Analysis were applied to explore data patterns related to voice symptoms. ResultsIwPD reported significantly fewer vocal symptoms than those with GVD in all VoiSS questionnaire domains. Multivariate principal component analysis found no significant correlations between VoiSS scores and participant similarities in voice measures. Despite experiencing hypophonia, IwPD scored lower in all VoiSS domains but still fell in the healthy voice range. Hierarchical Clustering Analysis grouped participants into three distinct categories, primarily based on age, vocal loudness, and VoiSS domain scores, distinguishing between PD and GVD individuals. ConclusionsIwPD reported fewer vocal symptoms than GVD. The voice self-assessment seems to be unreliable to assess vocal symptoms in IwPD, at least regarding loudness. New self-report instruments tailored to PD individuals are needed due to their particular voice characteristics.

¿Notas La Diferencia? [Do You Hear the Difference?]: Perceptual Consequences of Intensive Voice Treatment in Spanish Speakers With Parkinson's Disease.

The primary objective of this study was to explore the effects of intensive voice-focused treatment on speech parameters in Spanish speakers with dysarthria associated with Parkinson's disease (PD) as perceived by naïve listeners. Fifteen Spanish speakers with dysarthria associated with PD received the Lee Silverman Voice Treatment (LSVT LOUD) for a month. Voice and speech recordings were conducted pretreatment, posttreatment, and at a 1-month follow-up. Thirty naïve adult listeners rated the perceptual dimensions of ease of understanding (EoU), resonance, articulatory precision, prosody, and voice quality from sentences extracted from an emotional monologue on a visual analogue scale. EoU, resonance, articulatory precision, and voice quality significantly improved pre- to posttreatment, but gains were not maintained at follow-up. Speech severity was a significant source of variance in mean listener response for all perceptual dimensions, although the interaction between speech severity and time was only significant for resonance and voice quality. LSVT LOUD may be beneficial to improve perceptual speech domains affected by PD in Spanish speakers with dysarthria. Its impact on the different speech subsystems may reflect a universal distribution of effects when directly targeting the glottal source. Language-specific contributions of each perceptual domain to speech intelligibility should be explored in further research to determine linguistically sensitive treatment targets.

Survey of IP-based air-to-ground data link communication technologies

The main purpose of an air traffic management system is to provide air traffic services to an aircraft moving within the controlled airspace. Very high frequency (VHF) radio in continental regions, as well as high frequency (HF) radio and satellite communications in remote areas, are used today as the primary way of delivering air traffic services. The technical limitations and constraints associated with the current technology, such as line-of-sight requirement, vulnerability to interference, and limited coverage, cause degraded voice quality and discontinuity in service. At the same time, voice-based communication may affect flight safety due to poor language skills, call sign confusion, and failure to use standard phraseology. For this reason, text-based communication over a VHF data link (VDL) has been proposed as an alternative. However, it is predicted that VDL will be insufficient to support increasing air traffic and intensive data exchanges due to its lack of mobility support and limited resources to ensure service continuity. This paper surveys next-generation data link technologies based on the current state of the "industry standard" for aeronautical communication. These include Aeronautical Mobile Airport Communication System (AeroMACS), L-band Digital Aeronautical Communications System (LDACS), and Airborne New Advanced Satellite Techniques & Technologies in a System Integrated Approach (ANASTASIA). The paper also surveys IP-based text communication solutions over these next-generation data links. We analyze the efficiency of the proposed solutions with regard to service continuity and aeronautical application requirements. We conclude the survey by identifying open problems and future trends.

Effect of vocal loading on voice parameters in trainee actors

Introduction: Prolonged use of voice or vocal load can be a risk factor for individuals and can end up in vocal fatigue and dysphonia. Vocal loading can alter tissue structure and affect the voice quality forever. An obvious factor to be considered is the vocal use by a professional voice user. Actors are a group of professionals who can be affected by the long-term use of voice. There is a higher prevalence of inflammatory lesion in acting students and they were found to have poor vocal hygiene habits; which shows that these future elite vocal performers are at risk for developing a voice disorder. Aim: To study the objective and subjective changes in voice characteristics post vocal loading task in trainee actors. Method: A total 37 trainee actors (14 females and 23 males) participated in the study. The age range of the participants were 20 – 39 years and the range of the training period was 6 – 12 months. The participants were instructed to read a passage for 30 – 45 minutes at a loudness level of 70 – 80 dB SPL. Individuals with perceptually normal voice in terms of pitch and intensity and with a score less than 1 in GRBASI (Grade, Roughness, Breathiness, Asthenia, Strain, Instability) rating scale were included in the study. Acoustic, and perceptual evaluation were measured immediately before and after vocal loading task. Acoustic analysis was done using MDVP, whereas The Auditory Perceptual Rating Scale and GRABASI rating scale were used for perceptual analysis. Self-rating of the voice after vocal loading task was measured after the vocal loading task using Vocal Fatigue Index.1 Results and conclusion: The results revealed a significant difference in perceptual parameters post vocal loading task. The f0, jitter and HNR (Harmonic to Noise Ratio) showed a significant increase in the values after the vocal loading task. However, shimmer and RAP (Relative Amplitude Perturbation) did not show significant difference in the values post vocal loading task. The self-rating of the voice after the vocal loading task revealed that 54% of the trainee actors did not perceive vocal fatigue. The study hence shows significant effects of vocal loading in perceptual and acoustic analysis whereas the self-rating shows less perception of vocal changes in training actors. The acoustic, perceptual and self-rating of the voice quality before and after vocal loading task can aid in effective training and management of the trainee actors. However, the actors themselves are not equipped to measure the voice changes acoustically or perceptually and would take much longer time to perceive changes in their voice quality. Therefore, it is important to give a vocal hygiene programme in the preventive stage, that is, in the training period.

Effects of Deep-Brain Stimulation on Speech: Perceptual and Acoustic Data.

This study examined speech changes induced by deep-brain stimulation (DBS) in speakers with Parkinson's disease (PD) using a set of auditory-perceptual and acoustic measures. Speech recordings from nine speakers with PD and DBS were compared between DBS-On and DBS-Off conditions using auditory-perceptual and acoustic analyses. Auditory-perceptual ratings included voice quality, articulation precision, prosody, speech intelligibility, and listening effort obtained from 44 listeners. Acoustic measures were made for voicing proportion, second formant frequency slope, vowel dispersion, articulation rate, and range of fundamental frequency and intensity. No significant changes were found between DBS-On and DBS-Off for the five perceptual ratings. Four of six acoustic measures revealed significant differences between the two conditions. While articulation rate and acoustic vowel dispersion increased, voicing proportion and intensity range decreased from the DBS-Off to DBS-On condition. However, a visual examination of the data indicated that the statistical significance was mostly driven by a small number of participants, while the majority did not show a consistent pattern of such changes. Our data, in general, indicate no-to-minimal changes in speech production ensued from DBS stimulation. The findings are discussed with a focus on large interspeaker variability in PD in terms of their speech characteristics and the potential effects of DBS on speech.

An LSTM based DNN Model for Neurological Disease Prediction Using Voice Characteristics

INTRODUCTION: A neurological condition known as Parkinson's disease (PD); it affected millions of individuals worldwide. An early diagnosis can help enhance the quality of life for those who are affected with this disease. This paper presents a novel Deep neural network model based on Long Short-Term Memory (LSTM) design for the identification of PD using voice features.&#x0D; OBJECTIVES: This research work aims to Identify the presence of PD using voice features of individuals. To achieve this, a Deep neural Network with LSTM is to be designed. Objective of the work is to analyse the voice data and implement the model with good accuracy.&#x0D; METHODS: The proposed model is a Deep Neural Network with LSTM.&#x0D; RESULTS: The proposed method uses the features gleaned from voice signals for training phase of LSTM model which achieved an accuracy of 89.23%, precision value as 0.898, F1-score of 0.965, and recall value as 0.931and is observed as best when compared to existing models.&#x0D; CONCLUSION: Deep Neural Networks are more powerful than ANNs ahd when associated with LSTM , the model outperformed the job of identifying PD using voice data.

Clinical characteristics and efficacy of vocal fold epidermoid cysts coexisting with sulcus vocalis

Objective: To investigate the clinical characteristics and voice outcomes after laryngeal microsurgery for vocal fold epidermoid cysts coexisting with sulcus vocalis. Methods: The clinical data of 115 vocal fold epidermoid cysts coexisting with sulcus vocalis patients in Shandong provincial ENT hospital, were retrospectively analyzed, including 49 males and 66 females, aged 17-70 years old, and the duration of hoarseness ranged from 6 months to 30 years. All patients underwent surgery through suspension laryngoscope and microscope under general anestgesia. Ninety-four patients were treated with microflap excision of sulcus vocalis, cyst wall, and contents.And 21 patients that occulted with mucosal bridges were applied mucosal bridges resection (2 cases) and mucosal bridges reconstruction (19 cases) respectively. Videolaryngoscopy, subjective voice evaluation (GRBAS), objective voice evaluation, and Voice Handicap Index(VHI) were performed before and after surgery. All patients underwent histopathologic examination and follow-up after the procedure. The preoperative acoustic parameters of patients with vocal fold epidermoid cysts coexisting with sulcus vocalis were compared with those of vocal fold mucus retention cysts and simple vocal fold epidermoid cysts by independent samples t-test. The patients were compared by paired t-test for preoperative and postoperative parameters. Results: Significant reduction or lack of mucosal waves were shown via videolaryngostroboscopy in all 115 cases.In addition, vascular changes including dilation, tortuousness, increased branches, and abrupt direction change were shown on the cystic area. Eighty-one patients were detected cysts and/or sulcus vocalis by preoperative laryngoscopy, and intraoperative microscopic findings in the remaining 34 patients. The intraoperative microscopic examination revealed a focal pouch-like deficit plunging into the vocal ligament or muscle. The deep surface of the mucosal bridges was sulcus vocalis, and that in 89 cysts was lined with caseous content. Histopathology demonstrated a cystic cavity structure lined with squamous epithelium and caseous keratin desquamation inside the cystic cavity. Four of 115 patients were lost at follow-up and excluded from the analysis of voice outcomes after surgery. There was no significant mucosal wave and the voice quality in all but 14 patients 1month after surgery. Except for the fundamental frequency and noise harmonic ratio, all other voice parameters[ G, R, B, A, VHI-10, jitter, shimmer, maximum phonatory time (MPT) ]showed a significant improvement 3 months after surgery(t=15.82, 20.82, 17.61, 7.30, 38.88, 7.84, 5.88, -6.26, respectively, P<0.05). Then mucosal waves and the voice quality were gradually improved and became steady in 6 months after surgery. The subjective and objective voice parameters[G, R, B, A, VHI-10, jitter, shimmer, noise to harmonic ratio(NHR), MPT], except for the fundamental frequency, were all significantly improved(t=23.47, 25.79, 18.37, 9.84, 54.45, 10.68, 8.07, 3.24, -9.08, respectively, P<0.05). In addition, there were 2 patients with no significant improvement after the operation. Steady function with no complications was observed during the 12 months (up to 3 years in 34 patients) follow-up period in 111 patients. Conclusion: Ruptured vocal fold epidermoid cysts can result in sulcus vocalis and mucosal bridges. Characteristics changes in preoperative videolaryngoscopy are effective diagnostic tools. The complete excision of the cyst wall and repair of the lamina propria can lead to satisfactory long-term effects.

Oral-diadochokinesis between Parkinson's disease and neurotypical elderly among Malaysian-Malay speakers.

Parkinson's disease (PD) has an impact on speech production, manifesting in various ways including alterations in voice quality, challenges in articulating sounds and a decrease in speech rate. Numerous investigations have been conducted to ascertain the oral-diadochokinesis (O-DDK) rate in individuals with PD. However, the existing literature lacks exploration of such O-DDK rates in Malaysia and does not provide consistent evidence regarding the advantage of real-word repetition. To explore the effect of gender, stimuli type and PD status and their interactions on the O-DDK rates among Malaysian-Malay speakers. O-DDK performance of 62 participants (29 individuals with PD and 33 healthy elderly) using a non-word ('pataka'), a Malay real-word ('patahkan') and an English real-word ('buttercake') was audio recorded. The number of syllables produced in 8s was counted. A hierarchical linear modelling was performed to investigate the effects of stimuli type (non-word, Malay real-word, English real-word), PD status (yes, no), gender (male, female) and their interactions on the O-DDK rate. The model accounted for participants' age as well as the nesting of repeated measurements within participants, thereby providing unbiased estimates of the effects. The stimuli effect was significant (p < 0.0001). Malay real-word showed the lowest O-DDK rate (5.03 ± 0.11 syllables/s), followed by English real-word (5.25 ± 0.11 syllables/s) and non-word (5.42 ± 0.11 syllables/s). Individuals with PD showed a significantly lower O-DDK rate compared to healthy elderly (4.73 ± 0.15 syllables/s vs. 5.74 ± 0.14 syllables/s, adjusted p < 0.001). A subsequent analysis indicated that the O-DDK rate declined in a quadratic pattern. However, neither gender nor age effects were observed. Additionally, no significant two-way interactions were found between stimuli type, PD status and gender (all p > 0.05). Therefore, the choice of stimuli type has no or only limited effect considering the use of O-DDK tests in clinical practice for diagnostic purposes. The observed slowness in O-DDK among individuals with PD can be attributed to the impact of the movement disorder, specifically bradykinesia, on the physiological aspects of speech production. Speech-language pathologists can gain insights into the impact of PD on speech production and tailor appropriate intervention strategies to address the specific needs of individuals with PD according to disease stages. What is already known on this subject The observed slowness in O-DDK rates among individuals with PD may stem from the movement disorder's effects on the physiological aspects of speech production, particularly bradykinesia. However, there is a lack of consistent evidence regarding the influence of real-word repetition and how O-DDK rates vary across different PD stages. What this study adds to existing knowledge The O-DDK rates decline in a quadratic pattern as the PD progresses. The research provides insights into the advantage of real-word repetition in assessing O-DDK rates, with Malay real-word showing the lowest O-DDK rate, followed by English real-word and non-word. What are the potential or actual clinical implications of this work? Speech-language pathologists can better understand the evolving nature of speech motor impairments as PD progresses. This insight enables them to design targeted intervention strategies that are sensitive to the specific needs and challenges associated with each PD stage. This finding can guide clinicians in selecting appropriate assessment tools for evaluating speech motor function in PD patients.

The Voice of the People: Populism and Donald Trump’s Use of Informal Voice

Many studies have examined characteristic verbal aspects of Donald J. Trump’s political communication, from his authoritarian rhetoric to his preference for short words and simple sentences, as expressions of his populism. This article focuses on his use of non-verbal voice quality. In analyzing the “Trump rallies” and other materials from his successful campaigning before the 2016 United States presidential election, I argue that Trump’s evocative and meaningful uses of pitch, amplitude, speech rate, rhythm, and other vocal measures combine to make his paralanguage exceptionally and counter-normatively informal, and that this informality amplifies his explicitly populist messaging. I conclude by suggesting that Trump’s informal voice solves an important problem for him: It allows him to express his populism with a deeply personal undertone, and thereby potentially to make his claims to popular identification ring intuitively true.

Therapeutic Singing and Semi-Occluded Vocal Tract Exercises for Individuals with Parkinson's Disease: A Randomized Controlled Trial of a Single Session Intervention.

Individuals with Parkinson's disease (PD) experience speech and voice-related symptoms that diminish communication and quality of life. Semi-occluded vocal tract (SOVT) exercises are targeted interventions that, when combined with the positive psychosocial benefits of therapeutic group singing (TGS), may affect outcomes. The purpose of this study was to explore the effectiveness of SOVT exercises, specifically straw phonation combined with TGS, to improve voice quality and mood for individuals with PD. We used a true experimental pretest-posttest between-subjects design (i.e., randomized controlled trial) facilitated by a board-certified music therapist. All participants (N = 27) were randomly assigned to one of three groups (a) straw phonation combined with TGS (SP + TGS, n = 10), (b) TGS (n = 10), and (c) speaking-only control group (n = 7). Participants completed voice recordings for acoustic measures and the Visual Analogue Mood Scale for mood analysis before and after a 30-min intervention. The results demonstrated significant improvement in voice quality evidenced by decreasing Acoustic Voice Quality Index scores following a single session for both SP + TGS and TGS intervention groups when compared to the control. Happiness scores improved in the experimental groups when compared to control. Although not statistically significant, participants in the experimental groups (SP + TGS, TGS) demonstrated better mean mood scores on happiness, anxiety, and angry when compared to control, indicating a positive psychological response to the singing interventions. Overall, this study indicated the effectiveness of SP + TGS and TGS as promising therapeutic interventions for voice quality and mood in individuals with PD.

Listening effort, fatigue, and streamed voice quality during online university courses

Understanding the impact of listening effort (LE) and fatigue has become increasingly crucial in optimizing the learning experience with the growing prevalence of online classrooms as a mode of instruction. The purpose of this study was to investigate the LE, fatigue, and voice quality experienced by students during online and face-to-face class sessions. A total of 110 participants with an average age of 20.76 (range 18–28) comprising first year undergraduate students in Speech and Language Therapy and Audiology programs in Turkey, rated their LE during the 2022–2023 spring semester using the Listening Effort Screening Questionnaire (LESQ) and assessed their fatigue with the Multidimensional Fatigue Inventory (MFI-20). Voice quality of lecturers was assessed using smoothed cepstral peak prominence (CPPS) measurements. Data were collected from both online and face-to-face sessions. The results revealed that participants reported increased LE and fatigue during online sessions compared to face-to-face sessions and the differences were statistically significant. Correlation analysis showed significant relationships (p < 0.05) between audio-video streaming quality and LE-related items in the LESQ, as well as MFI sub-scales and total scores. The findings revealed a relationship between an increased preference for face-to-face classrooms and higher levels of LE and fatigue, emphasizing the significance of these factors in shaping the learning experience. CPPS measurements indicated a dysphonic voice quality during online classroom audio streaming. These findings highlight the challenges of online classes in terms of increased LE, fatigue, and voice quality issues. Understanding these factors is crucial for improving online instruction and student experience.